Abstract

It is virtually a cliché that care‐giving was one of woman's primary duties. However, we often have little appreciation of the actual experience. Emily Abel induces a visceral understanding of this critical role, starting from the first chapter of Hearts of Wisdom, with the life of Emily Hawley Gillespie, a farmwoman in the Midwest in the nineteenth century. Gillespie assisted neighbors and friends during childbirth and sickness. She was herself recipient of such help when ill and for the birth of her children. Moreover, despite tense relationships with her father and her sister, Gillespie cared for them when the need arose. There was tension between her and her daughter, Sarah. Despite the fact that Sarah had a teaching position in another community, she returned to her mother's house in times of medical crises. As Emily's health failed, Sarah resigned in order to nurse her mother. This story documents how care‐giving dominated many women's lives. Emily, Sarah, and other women of the nineteenth century considered care‐giving a labor of love and, at the same, took pride in their accomplishments.Slowly, though, from the turn of the century onward, physicians increasingly sought to assert their growing professional status. They chafed at lay care‐givers who sometimes undercut and even contradicted medical advice. The balance of power between care‐giving mothers and physicians shifted in the twentieth century for several reasons, not solely because of enhanced medical authority built on new medical knowledge in areas such as bacteriology and new medical practice, especially surgery. Changes in domestic technology, developments in transportation and communications, and the spread of hospitals, for example, all combined to affect women's family care‐giving. In another extensive and telling vignette, Abel traces more than thirty years of Martha Shaw Farnsworth's life, dramatically illustrating how care‐giving and medicine changed between 1890 and 1924. True, as medical care moved from the home into the hospital, women spent less time in direct care. However, they did not relinquish their control over medical situations, instead insisting on participating in medical decision‐making for themselves and for others. In effect, their care‐giving role was redefined from one of personal care to one of mediator between the patient and the health‐care provider.The bulk of this study centers on the lives of literate white women coping with physical illness. Recognizing this limitation, Abel investigates the lives of other women in other situations that involve care‐giving. One particularly fascinating chapter highlights immigrant women caring for family members diagnosed in the early twentieth century with tuberculosis. They often clashed with medical and charity workers. In another chapter, Abel shows the influence of the Depression, using letters written to Eleanor and Franklin D. Roosevelt by poor mothers negotiating health care for their families. Two other chapters cogently discuss the mothers of children labeled feebleminded and epileptic and the mothers of deaf children.Emily Abel's Hearts of Wisdom is a carefully crafted study interweaving the history of American women and the history of medicine. The richness of the sources she uses—the diaries and the letters especially—adds a sense of immediacy and power to her analysis. Attuned to racial and ethnic differences as well as regional and socioeconomic distinctions, Hearts of Wisdom demonstrates that female care‐giving was both a reflection of contemporary medical developments and independent of them. Women caring for their families found themselves balancing confidence in their own empathic knowledge with the authoritative knowledge of health‐care professionals. By focusing on the role of female care‐giver, Abel has drawn an insightful and evocative picture of women's changing roles during a period of dramatic transformations in medical care and the medical profession